2018 UMASS Summer Field Hockey Program & MAX Goalkeeping Academy Registration
Please complete the following information to register for the 2018 UMASS Summer Field Hockey Program & MAX Goalkeeping Academy. The program is open to any and all females entering grades 8-12 in the Fall of 2018. Field player and goalkeeper registration is the same.

After successfully submitting your registration, please mail a check for $425 made out to "WMass HKY" to: WMass HKY, 16 Foxglove Lane, Amherst, MA 01002. If you would like to submit your payment online using a credit card, you may do so at the following link (you will be responsible for the processing fee: $12.63): http://wmasshky.com/payment-umass-summer-program

If you have any questions, please contact us at wmasshky@gmail.com.

PARTICIPANT INFORMATION
First Name *
Your answer
Last Name *
Your answer
School Grade Entering Fall 2018 *
Primary Position *
Years of Experience *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Email Address *
Your answer
Phone Number *
Your answer
School Name *
Your answer
Club Name (Optional)
Your answer
PARENT/GUARDIAN #1 INFORMATION
First Name *
Your answer
Last Name *
Your answer
Email Address *
Your answer
Phone Number *
Your answer
PARENT/GUARDIAN #2 INFORMATION (Optional)
First Name
Your answer
Last Name
Your answer
Email Address
Your answer
Phone Number
Your answer
EMERGENCY CONTACT PERSON
Must be someone other than the parent contacts
First Name
Your answer
Last Name
Your answer
Phone Number
Your answer
Relationship to Participant
Your answer
ADDITIONAL INFORMATION
Reversible Jersey Size *
Roommate Request
Your answer
Food Allergies
Your answer
Any additional information you would like to provide?
Your answer
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